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Fabricated or induced illness in children: A guide for Australian health-care practitioners
Joanna Tully1, Oliver Hopkins2, Anne Smith1
1Victorian Forensic Paediatric Medical Service, Royal Children's Hospital and Monash Children's Hospital, Melbourne, Victoria, Australia.
Insights
Fabricated or Induced Illness in a Child (FIIC) is a complex paediatric issue that may be underdiagnosed. Early recognition and a multidisciplinary approach are key to effective management of FIIC.
Area of Science:
- Medical Science
- Paediatrics
- Child Health
Background:
- Fabricated or Induced Illness in a Child (FIIC) presents diagnostic challenges in paediatric care.
- Healthcare practitioners may overlook FIIC despite accumulating evidence.
- The condition is likely more prevalent than commonly perceived.
Purpose of the Study:
- To enhance recognition and response to suspected FIIC among Australian healthcare practitioners.
- To provide guidance on reporting concerns to protective services.
- To clarify communication strategies with families and the role of forensic paediatric services.
Main Methods:
- This article provides a strategic approach for paediatricians.
- It emphasizes raising awareness and facilitating early intervention.
- It advocates for a multidisciplinary team approach to management.
Main Results:
- FIIC can be identified earlier than often assumed.
- Effective management is achievable through a structured, collaborative strategy.
- Addressing FIIC can be integrated into standard complex paediatric care.
Conclusions:
- A proactive, multidisciplinary strategy can improve the identification and management of FIIC.
- Early intervention is crucial for positive outcomes in children with FIIC.
- Paediatricians can effectively manage FIIC by adopting a systematic approach.
Abstract:
Many paediatricians have, or will have at some time in their career, a child under their care who has, or is suspected to have, Fabricated or Induced Illness in a Child (FIIC). Often a pattern of investigation, treatment and referral develops, with things 'just not quite adding up' and the diagnosis of FIIC is not considered. How can Australian health-care practitioners better recognise and respond to concerns around fabricated or induced illness? When should concerns be reported to protective services? How should we talk to families when we suspect fabrication or induction of illness in their child, and what is the role of specialised forensic paediatric services in Australia in relation to such cases? FIIC is almost certainly not as rare as commonly perceived and it can be identified early. Although challenging, FIIC can be managed effectively with a thoughtful multidisciplinary team approach. This article aims to provide paediatricians with a strategy that will hopefully serve to raise awareness, facilitate earlier intervention and simplify the approach to management, encouraging the view that taking action need be no different to addressing any other complex paediatric problem.
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